Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 0101269044 | VA |
NPI | 1073909990 |
---|---|
Provider Name | Nicole Claire Vissichelli |
First Address | Richmond, VA 23298-5051 |
Second Address | Richmond, VA 23298-5051 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2015 |
Last Update Date | 11/08/2020 |